1852 Michael Point Dr
Use BLUE or BLACK Ink
I For Off[ce Use
Permit M
City of Eap
I' Permit Fee:
i
3830 Pilot Knob Road l
Eagan MN 55122 1 Date Received: I
Phone: (651) 675-5675 l 1
Fax: (651) 675-5694 1' staff: I
w.- rw....-+ _____-.,..J
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date 17 / Site Address: Unit
Name: Phone
Resident/ 'V. ~4 'A
Owner Address I City l Zip:.-
f Applicant is: Owner f Contractor
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Description of work: '
i Type of Work -
1 Construction Cost: w Multi-Family Building: (Yes / No )
e Or
Contact: 1
Company; L
Aridrt 1 tta.~+t (N!!st r r' ~r ' r' ux " r`.)
Contractor City. r
State: ts) Zip: = Phone: '
s
License Lead Certificate M If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
t
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
E
_Yes -No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor. - Phone:
Sewer & Water Contractor: _ Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the Information may be classified as non-public if you provide specific reasons that would permit the City to
conch de that they are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0042 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.-cm I ' ~ri~cv ' oc
I hereby ac;knowic dge that this Information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan: that I f.in ierstancJ this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with tile, approved plan in the case of work which requires a review and approval of plans.
Exteriorwork authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 186
days of permit issuance.
A ijlicarnt's Printed Name Applicant's s signature
Page 1 of 3
F.: Eoice Use
City of Ea i ~ Permit
Permit Fee:
3830 Pilot Knob Road
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff: I
I 1
2008 RESIDENTIAL BUILDING PERMIT APPLI AT O
Date: Site Address:
Tenant: Suite
RESIDENT / OWNER Name: Phone:
Address / City / Zip:
Applicant is: Owner Contractor
TYPE OF WORK Description of work: ~CjC!-112
Construction Cost:c 2 i Multi-Family Building: (Yes, / No
CONTRACTOR Name:_ 6 ! f Z'- /Vif 1;,7 1e,17 v7Cf~ License
Address: _21Z)0 GGY1? l 2Y~O
City: Ajiliz6wl State: ~'d771r7 Zip: -55,1,3
Phone: !C>1.- 3 ,~0 3 fPZ,-0 Contact Person:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Minnesota Rules 7670 Category 1 Minnesota Rules 7672
Energy Code Residential Ventilation Category'l Worksheet New Energy Code Worksheet
Category Submitted Submitted
(4 submission type) - Energy Envelope Calculations Submitted
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE. Plans and suppdrting documents that you submit are considered to' h - public information. Portions of
the information may be classified as non-public if you provide specific reasons that Would permit the City to
conclude that the are trade secrets.
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of 1
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
,ccordance with the approved plan in the case of work which requires a review and approval of plans.
Applicant's Printed Name C Applic is ignature
Page f 3